Medwave最新文献

{"title":"The caregiving work experience of healthcare workers in Chile during the COVID-19 pandemic and its impact on mental health: A qualitative study based on the international initiative HEROES.","authors":"Jorge Ramírez, Victoria Lermanda, Antonia Aguirre, Sebastián Villarroel, María Soledad Burrone, Valentina Carrera, Felipe Castañeda, Rubén Alvarado, Paula Bedregal","doi":"10.5867/medwave.2024.07.2952","DOIUrl":"10.5867/medwave.2024.07.2952","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has impacted the mental health of healthcare workers. Studying the care perspective is essential to understanding the causes of specific mental health findings and proposing strategies to address them.</p><p><strong>Methods: </strong>Cross-sectional study with a thematic analytical approach, derived from the international initiative \"The Health Care Workers Study\" (HEROES), conducted among healthcare workers in Chile during the second semester of 2022 and the first of 2023 through semi-structured interviews and inductive coding.</p><p><strong>Results: </strong>A narrative synthesis of 35 interviews in four themes: care at work: the presence of changes in work tasks, concern about becoming infected, collective \"mystique\", stigma due to being a healthcare worker, conflicts with patients; care at home: multiple ways of arranging household tasks, the relevance of living with others, interrelation with work dynamics, \"double burden\" among women; relationship with one's own mental health: recognition of mental health impact, the stress associated with change and uncertainty, perception of work overload, feelings of guilt or responsibility for infecting family members; and beliefs and values about the pandemic and its effects: acceptance of psychological impact on healthcare workers, organizational culture as a relevant element in postponing one's own mental health, initial disbelief in the effects of the pandemic, similarities with previous periods of social upheaval, and equality among people in terms of vulnerability to the disease.</p><p><strong>Conclusions: </strong>Five elements emerge as potential areas for intervention: gender perspective, previous exposure to crisis experiences, self-care spaces, peer support, and institutional response. The care perspective helps study the relationship between some stressors and healthcare workers' mental health in the context of a pandemic.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2952"},"PeriodicalIF":1.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late diagnosis of disseminated tuberculosis: A case report.","authors":"Luis Alejandro Rodriguez-Hidalgo, Diana Cecilia Ruíz Caballero, Amalia Vega-Fernandez","doi":"10.5867/medwave.2024.07.2917","DOIUrl":"https://doi.org/10.5867/medwave.2024.07.2917","url":null,"abstract":"<p><strong>Introduction: </strong>The lungs are most commonly involved in tuberculosis, but infection can also involve other organs through lymphohematogenous dissemination. The clinical presentation of disseminated tuberculosis is variable. Diagnosis is difficult, because clinical manifestations are diverse, more than 50% of patients present late, because microbiological testing relies on invasive procedures for mycobacterial culture and supportive histopathology.</p><p><strong>Case report: </strong>A 30-year-old male patient, deprived of his liberty, with no co-morbidities, was admitted to the hospital for severe pain in the left wrist, with a previous history of having received systemic glucocorticoids for 7 months. He developed clinical symptoms of pulmonary tuberculosis, in the pleura, in the joint of the left wrist and in the left testicle, and tests confirmed the presence of M. tuberculosis. He underwent surgery on the wrist and testicle and was also treated for susceptible tuberculosis. Concomitant sequelae of iatrogenic Cushing's disease, chronic anemia and chronic inactive proctitis were diagnosed.</p><p><strong>Conclusions: </strong>Diagnosis of disseminated tuberculosis was difficult due to the non-specific clinical picture, limitations of confirmatory diagnostic tools and timely specialized evaluations. Prolonged use of systemic corticosteroids may have played a role in the dissemination of tuberculosis.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2917"},"PeriodicalIF":1.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health conditions of migrant children and adolescents from Latin America and Caribe: A narrative review.","authors":"Alejandra Carreño Calderon, Alice Blukacz, Baltica Cabieses, Alexandra Obach, Andrea Ortega","doi":"10.5867/medwave.2024.07.2931","DOIUrl":"https://doi.org/10.5867/medwave.2024.07.2931","url":null,"abstract":"<p><p>The presence of children and adolescents in migratory flows is growing in Latin America and the Caribbean. Little is known about migration's effects on these groups' health. This article aims to investigate the evidence available on the access and use of healthcare services by migrant children and adolescents in Latin America and the Caribbean. We seek to explore the role of social determinants of health at different levels in the health conditions of these groups. Also, to identify potential recommendations for healthcare systems and public policy to address them. For this purpose, a narrative review of 52 publications was carried out based on a search of scientific literature in the Web of Science and Google Scholar databases. Five relevant topics were identified: use of emergency care associated with lack of healthcare access, preventive services, and other social determinants of health; exposure to preventable infectious diseases; mental health; sexual and reproductive health; and vaccinations and dental health. We conclude that the evidence shows the need to address the inequities and disadvantages faced by migrant children from a perspective of social determinants of health and policies that consider health as a human right regardless of the migratory status of children and adolescents, as well as that of their parents or primary caregivers.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2931"},"PeriodicalIF":1.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic ectopia cordis: A case report.","authors":"Fabian Andres Merchan Bustos, Isabel Cristina Mesa-Cano, María Graciela Merchán-Coronel, Andres Alexis Ramírez-Coronel, Xavier Rodrigo Yambay-Bautista, Braulio Fernando Álvarez-Loja","doi":"10.5867/medwave.2024.07.2789","DOIUrl":"10.5867/medwave.2024.07.2789","url":null,"abstract":"<p><p>Ectopia cordis is a congenital heart malformation of the sternal wall, with a prevalence of 0.1% among heart conditions and an incidence of 5.5 to 7.9 per million births. It is characterized by the heart being located outside the thoracic cavity, and it may be accompanied by other congenital anomalies such as omphalocele, Cantrell´s pentalogy, or Fallot´s tetralogy. We present a case of thoracic ectopia cordis in a male neonate. After birth, we also observed a midline thoracic malformation and respiratory difficulties with clinical and paraclinical features consistent with tetralogy of Fallot. It was decided to provide skin flap coverage, and due to the poor prognosis of the heart condition, palliative care was chosen. Unfortunately, the neonate passed away after seven days. This clinical case study contributes to understanding this rare condition and may help improve diagnosis and treatment of affected patients.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2789"},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of high-energy trauma in Chile: An ecological analysis using public registries.","authors":"Maximiliano Barahona, Anselmo Alegría, Camila Amstein, Marcela Cárcamo, Macarena Barahona","doi":"10.5867/medwave.2024.07.2929","DOIUrl":"https://doi.org/10.5867/medwave.2024.07.2929","url":null,"abstract":"<p><p>High-energy trauma is defined as severe organic injuries resulting from events that generate a large amount of kinetic, electrical, or thermal energy. It represents a significant public health concern, accounting for 10% of global mortality. This article aims to describe the epidemiology of high-energy trauma in Chile. Specifically, it seeks to compare the mortality rate per 100 000 inhabitants among member countries of the World Health Organization (WHO), provide a descriptive analysis of notifications under the Explicit Health Guarantees (GES) for the health issue of polytraumatized patients, and analyze the trend in the mortality rate due to external causes in Chile. This study employs an ecological design using three open-access databases. First, the WHO database on deaths from traffic accidents in 2019 was used. Then, the GES database was consulted for the \"Polytraumatized\" issue between 2018 and 2022. Finally, the Chilean Department of Health Statistics database on causes of death between 1997 and 2020 was utilized. In 2019, Chile ranked in the middle regarding the mortality rate per 100 000 inhabitants due to traffic accidents. GES notifications for polytrauma predominantly involved men aged 20 to 40 years and those affiliated with the public health system, highlighting a primary focus for prevention efforts. Mortality from accidents showed a decreasing trend, with significant structural changes identified in 2000 and 2007.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2929"},"PeriodicalIF":1.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hypopressive exercise associated with aerobic and muscle strength training on the treatment of fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecologic cancer: A randomized clinical trial protocol.","authors":"Lily Berríos-Contreras, Luz Alejandra Lorca, Mariana Arias Avila, Francisco Ortega, Ivana Leao Ribeiro","doi":"10.5867/medwave.2024.07.2906","DOIUrl":"https://doi.org/10.5867/medwave.2024.07.2906","url":null,"abstract":"<p><strong>Introduction: </strong>Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer.</p><p><strong>Objective: </strong>Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training.</p><p><strong>Methods: </strong>This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention.</p><p><strong>Expected results: </strong>The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2906"},"PeriodicalIF":1.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Public policies and right to sexuality of the elderly in Chile].","authors":"Pedro Enrique Villasana López, María Mireya Abarca Castillo, Martín Patricio Vargas Matamala","doi":"10.5867/medwave.2024.07.2786","DOIUrl":"https://doi.org/10.5867/medwave.2024.07.2786","url":null,"abstract":"<p><p>People over 65 years of age will constitute the majority of the world's population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 7","pages":"e2786"},"PeriodicalIF":1.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical education for undergraduate research: Proposals from the experience of two national student conferences of the Universidad de Valparaíso.","authors":"Carlos Cabrera-Ubilla, Sebastián Almarza Santander, Marcelo Arancibia, María Elizabeth Guerra-Zúñiga","doi":"10.5867/medwave.2024.06.2959","DOIUrl":"https://doi.org/10.5867/medwave.2024.06.2959","url":null,"abstract":"<p><strong>Introduction: </strong>Scientific research promotes the development of essential skills for medical practice. However, student participation in research projects is low, with multiple limitations and students' perceptions of deficient research skills. This study aims to describe the organization of the two medical student conferences held by the Scientific Society of Medical Students of the Universidad de Valparaíso and to analyze the papers presented. Finally, we make recommendations for promoting scientific research among medical students.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted, including all the presentations given at the conferences.</p><p><strong>Results: </strong>The conferences comprised four phases: registration, evaluation, selection, and presentation. A total of 399 papers were received. A total of 157 case reports and 12 cross-sectional studies were presented, including 797 authors (56.7% women) from 21 universities. Most of the first authors were women in the internship cycle at public universities. The specialties with the highest representation were internal medicine (32.5%), pediatrics (18.3%) and surgery (13%). In the case reports, the best-evaluated section was the title (6.66 ± 0.76), and the worst-evaluated section was the discussion (6.17 ± 0.84). The case reports from private universities scored significantly higher in six of the eight items assessed.</p><p><strong>Conclusions: </strong>Greater participation was represented by students in their internship cycle presenting case reports. The worst evaluated section was the discussion, which could reflect difficulties in the research process. It is crucial to increase student participation from the first years of the career and encourage their involvement in research. More studies are needed to evaluate student participation and barriers to scientific research.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 6","pages":"e2959"},"PeriodicalIF":1.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of leukemia and risk estimation in working age population between provinces of Ecuador.","authors":"Antonio Ramón Gómez-García, Esteban Fernandez-Moreira, Xavier García-León, Manuel Gómez Del Moral","doi":"10.5867/medwave.2024.06.2903","DOIUrl":"10.5867/medwave.2024.06.2903","url":null,"abstract":"<p><p>Leukemia is associated with exposure to radiation, benzene derivatives, and pesticides. Previous research has documented an increase in work-related leukemia in the Latin American Andean region. To date, there are only few studies in Ecuador on the impact of oil exploitation on adjacent indigenous communities. Our study aims to show the impact of leukemia on the working-age population. For the calculation of morbidity and mortality rates, we used hospital discharge and death records from the National Institute of Statistics of Ecuador. These data were collected and adjusted to the corresponding province's population for further analysis. Large differences were observed between provinces in adjusted rates of leukemia mortality and morbidity in the working-age population. The variations in altitude among different areas in Ecuador give the provinces a distinct geographic identity. Likewise, the provinces with the highest morbidity and mortality rankings, such as Azuay, Loja, Imbabura, and Tungurahua, have an average altitude above 2000 meters. As a result, there are variations in the average temperature, exposure to solar and cosmic radiation, and mining and farming methods. The observed differences warrant the future collection of geolocation data for affected individuals. This could help to better understand how leukemia cases have demogrpahic hotspots in the country, identify possible risk factors associated with the disease in each region, and design more effective prevention and control strategies.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 6","pages":"e2903"},"PeriodicalIF":1.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The postmodern subject from a psychopolitical perspective: An analysis from logotherapy.","authors":"Julio Cesar Suarez Luna","doi":"10.5867/medwave.2024.06.2799","DOIUrl":"https://doi.org/10.5867/medwave.2024.06.2799","url":null,"abstract":"<p><p>From a hermeneutic interpretation, this article analyzed the new psychic pandemic configuring a typology of psychopolitical man, provided by digital swarms and mass psychology, that, from logotherapy, can be perceived as a postmodern collective neurosis. We also analyze a self's hyper-reflection as a social phenomenon of psychopolitics, suffering as repression, and the love of narcissistic consumption. Consolidating a sense of life as a social ethos is the answer to finding compromises and responsibility for the individual mission that every human being has as a member of a community and society.</p><p><p>En este ensayo se abordó la nueva pandemia psíquica desde una interpretación hermenéutica. Esta pandemia configura una tipología de persona psicopolítica, dada por enjambres digitales y una psicología de masas que, desde la logoterapia, se puede percibir como neurosis colectivas postmodernas. También se puede analizar como fenómenos sociales de la psicopolítica. Esta es una hiperreflexión del propio yo, el sufrimiento como represión y el amor de consumo narcisista. El consolidar un sentido de vida como ethos social, es la respuesta para hallar compromisos y responsabilidad ante la misión personal que tiene cada ser humano como miembro de una comunidad y sociedad.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"24 6","pages":"e2799"},"PeriodicalIF":1.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}